ABSTRACT

Verruciform Xanthoma of the vulva is an extremely rare entity, the etiology of which is unknown. The diagnosis is almost always made on histopathological examination. There have been only 7 cases of Verruciform Xanthoma reported worldwide to date.

A lady aged 30 years with 2 children presented with the complaints of copious white discharge per vagina and vulval swelling of 5 years duration. She had received antibiotics and antiviral drugs for the same. On examination three plaque like lesions were seen on both the labia minora each measuring 2 x 1 cm. Vaginal smear examination, vaginal Swab culture, TPHA and VDRL, HIV, HSV, HPV & Mantoux were negative. Endometrial tissue did not show any growth on culture and was negative for Tuberculosis by PCR. A diagnosis of Verruciform Xanthoma of vulva was made on histopathological examination of the biopsied tissue from the vulval swelling by the presence of Foam cells. There was no evidence of Tuberculosis, fungal & parasitic infection or malignancy. The lady was advised to undergo surgery (Complete excision of the vulval lesions) for the vulval Xanthoma. However, she did not follow-up in spite of all communication efforts.

Verruciform Xanthoma of the vulva is an extremely rare entity which cannot be diagnosed clinically. It needs to be differentiated from other rare vulval lesions resembling it. Hence, all such patients need to be approached meticulously in a centre having the necessary diagnostic modalities and expertise in managing such rare cases.

Keywords: Verruciform xanthoma, Vulval xanthoma, Foam cells